FORM GC-121 Ct Minor Petition to Appt for Settl Only

• Legal Form Number: FORM GC-121
• Date: 01 January 2024
• Section: AZ GC Forms Annotated

FORM GC-121

(Attorney's name, State Bar No.)

(Attorney's law firm name)

(Law firm bar number)

(Address)

(Phone number)

(Attorney or firm's e-mail address)

Attorney for: __________

SUPERIOR COURT OF ARIZONA, __________ COUNTY

In the Matter of the Conservatorship for: a Minor. NO. __________ PETITION FOR APPOINTMENT OF [SPECIAL] CONSERVATOR FOR A MINOR AND APPROVAL OF SETTLEMENT AND DISTRIBUTION OF PROCEEDS

Pursuant to A.R.S. §§ 14-5404 [, -5409] and -5424(D) and Rule 53(a) of Ariz. R. Prob. P., Petitioner, __________, states:

1. Pursuant to A.R.S. § 14-5403, venue for this proceeding is in this county because the person in need of protection, (minor's name) [resides] [does not reside in Arizona but has property] in this county.

2. Petitioner is interested in this matter because _________.

3. (Minor's name) is an unmarried minor whose name, age, current residence and permanent address are:

Name:

Age:

Current Residence:

Permanent Address, if different:

4. Pursuant to A.R.S. § 14-5410(A), (nominee's name), whose address and telephone number are ____________, has priority for appointment as conservator because (identify nominee's priority) and is willing to act on behalf of (minor's name). [The nominated conservator is filing the affidavit required by A.R.S. § 14-5106(A).] [The nominated conservator is a financial institution or a public fiduciary and is excused from completing the affidavit required by A.R.S. § 14-5106(A).]

5. [(Minor's name) currently has no guardian.] [The name and address of (minor's name)'s guardian are: __________.]

6. [(Minor's name) currently has no conservator.] [The name and address of (minor's name)'s conservator are: __________.]

7. The name(s) and address(es) of (minor's name)'s nearest relative(s) known to Petitioner are:

Name:

Address:

Relationship:

[Repeat as necessary.]

8. The following is a general statement of the property owned by (minor's name), with an estimate of its current fair market value and including any compensation, insurance, pension, or allowance to which (minor's name) is entitled, as known by Petitioner as of the date of this petition:

Cash (i.e. checking, savings, certificates of deposit, etc.)	$
Marketable securities (i.e., stocks, bonds, brokerage accounts, etc.)	$
Other Personal Property	$
Real Property	$
TOTAL	$

Annual Income and Compensation

Social Security	$
Periodic payments and/or death benefits	$
Dividends and Interest	$
Other	$
TOTAL	$

9. Pursuant to A.R.S. § 14-5401(A)(1), the appointment of a [special] conservator [or other protective order] is necessary because (minor's name) [owns money or property that requires management or protection that cannot otherwise be provided] [has or may have affairs that might be jeopardized or prevented by minority] [needs funds for support and education and protection is necessary or desirable to obtain or provide funds].

10. (Minor's name) is entitled to receive monetary assets or funds from [insurance proceeds] [inheritance] [death benefits] [periodic receipt of funds] [investment accounts] which need to be managed or protected. In particular, _________ [explain].

11. (Minor's name) is entitled to receive monetary assets or funds from a civil claim for personal injury or wrongful death. (Minor's name)'s pending claim arises from the following facts: __________ [explain circumstances of civil claim].

12. The parties involved in the civil claim have reached an agreement, subject to court approval, for settlement of the claim that would result in payments being made to or for (minor's name)'s benefit. The proposed settlement is in (minor's...